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Topic:Prognosis
Prognosis in horses refers to the prediction of the likely outcome or course of a disease or injury in equine patients. It involves assessing various factors such as the nature and severity of the condition, the horse's overall health, and response to treatment. Prognostic evaluations help veterinarians and horse owners make informed decisions regarding treatment options, management strategies, and potential recovery. The process often incorporates clinical assessments, diagnostic tools, and historical data to estimate the chances of recovery or progression. This page compiles peer-reviewed research studies and scholarly articles that explore methodologies, factors influencing prognostic outcomes, and the implications of prognostic evaluations in equine veterinary practice.
Expression of inflammation-associated genes in circulating leukocytes collected from horses with gastrointestinal tract disease. To investigate whether expression of inflammation-associated genes in leukocytes from horses with gastrointestinal tract (GIT) diseases correlated with the type of disease and outcome. Methods: 10 healthy horses and 50 horses with GIT disease. Methods: A blood sample was collected from each healthy horse or horse with GIT disease (during admission to the hospital). Leukocytes were isolated, diluted to a standard concentration, and frozen until RNA extraction. Expression of 14 genes associated with inflammation was quantified by use of a real-time quantitative reverse transcription PCR assay. R...
The propagation of induced tendon lesions in the equine superficial digital flexor tendon: an ex vivo study. Clinical tendon lesions usually enlarge during the first days to weeks after sustaining the injury due to enzymatic and biomechanical influences. Limiting this enlargement would positively influence prognosis related to lesion size. Objective: To investigate the effect of cyclic loading on the propagation of enzymatically and physically induced tendon lesions and to assess the effect of immobilisation thereon in an ex vivo model. Methods: Equine cadaver limbs with either physically or collagenase-induced SDFT lesions were placed in a pneumatic loading device. Groups consisted of unloaded limbs...
Outcome and long-term follow-up of 20 horses undergoing surgery for caecal impaction: a retrospective study (2000-2008). If untreated, caecal impaction may progress to rupture of the caecum and reports of long-term outcome for horses undergoing surgery for caecal impaction are required. Objective: To describe short- and long-term complication rates for horses undergoing surgery for caecal impaction in an otherwise life-threatening gastrointestinal condition. Methods: Case records were reviewed for horses undergoing surgery for caecal impaction. Horses were included in the study if an abnormally large, fluid-distended or feed-impacted caecum was the primary diagnosis at surgery and excluded if the caecum had alre...
Peritoneal concentrations of transforming growth factor beta in horses with colic. In man, peritoneal transforming growth factor beta (TGF-beta) is associated with peritoneal diseases and subsequent adhesion formation. No studies on plasma and peritoneal TGF-beta concentrations in horses with colic are available. Objective: 1) To determine both plasma and peritoneal TGF-beta(1) and TGF-beta(3) concentrations in horses with different types of colic (not previously subjected to abdominal surgery); 2) to compare these concentrations according to the type of peritoneal fluid (transudate, modified transudate and exudate); and 3) to compare and correlate plasma and peritoneal conc...
Size and geometry of apical sesamoid fracture fragments as a determinant of prognosis in Thoroughbred racehorses. Analysis was performed to examine a method for refining the preoperative prognosis for horses that had surgery to remove apical fractures of the proximal sesamoid bones (PSBs). Objective: To determine if: 1) there was a difference in size or configuration of apical fractures between the different anatomical locations of the PSBs, which have been shown to affect the prognosis; and 2) the size or configuration could predict the prognosis for racehorses with these fractures. Methods: The study included 110 weanlings and yearlings and 56 training racehorses that underwent surgery to remove apical ...
Muscle strain injuries of the hindlimb in eight horses: diagnostic imaging, management and outcomes. To describe the clinical presentation, ultrasound findings, management and outcome in horses with muscle tear injuries of the hindlimbs. Methods: Retrospective case series Procedure Medical records of eight horses were reviewed and information on signalment, history, presenting complaint, physical examination findings and further diagnostic tests were recorded. Diagnosis of muscle injury was determined by the presence of abnormal ultrasound findings, compared with the contralateral limb, and, when required, nuclear scintigraphy. Follow-up information was obtained via telephone interviews with ...
The use of CT and CT arthrography in diagnosing equine stifle injury in a Rheinlander gelding. A 5-year-old Rheinlander gelding was evaluated for left hindlimb stifle lameness. The lameness was localised to the stifle, but source of the lameness was not specifically diagnosed from the physical, radiographic and ultrasonographic examinations. Computed tomography (CT) and CT arthrography were therefore used for further investigation since these imaging techniques image bony structures, cartilage and soft tissues. This examination showed multiple lesions in the stifle: an osteochondrosis dissecans like lesion of the medial femoral condyle, bony fragments, cartilage trauma and caudal crucia...
Bacterial culture of septic synovial structures of horses: does a positive bacterial culture influence prognosis? The influence of synovial fluid culture on short- and long-term prognosis of cases with septic synovitis requires study. Objective: Horses with a positive bacterial culture from septic synovial fluid are less likely to survive or return to successful athletic function than those with a negative bacterial culture from septic synovial fluid. Methods: Records of mature horses presented to 2 equine referral hospitals for investigation of suspected septic synovitis were examined. Horses (n=206) were included in the study if synovial fluid was submitted for full laboratory examination, including bac...
Resection and anastomosis of the descending colon in 43 horses. To determine (1) the short- (to hospital discharge) and long- (>6 months) term survival, (2) factors associated with short-term survival, and (3) the perioperative course for horses with resection and anastomosis of the descending colon. Methods: Multicentered case series. Methods: Horses (n=43) that had descending colon resection and anastomosis. Methods: Medical records (January 1995-June 2009) of 7 equine referral hospitals were reviewed for horses that had descending colon resection and anastomosis and were recovered from anesthesia. Retrieved data included history, results of clinical ...
Antimicrobial delivery by intrasynovial catheterisation with systemic administration for equine synovial trauma and sepsis. To present the technique for intra-articular catheter placement and report the clinical outcomes of 38 cases of equine synovial trauma and/or infection treated with broad-spectrum antimicrobials administered via an intrasynovial catheter (ISC). Methods: Retrospective study. Methods: Medical records of 38 horses treated for synovial trauma and sepsis with frequent antimicrobial administration through an ISC from 1995 to 2008 were reviewed. Follow-up information was obtained via clinical re-evaluation or telephone contact with the owners. Results: The majority of horses (84%) received amikacin a...
Clinical presentation, diagnosis, and prognosis of chronic laminitis in North America. Chronic laminitis involves laminar morphologic changes resulting in digital collapse and can vary greatly in its clinical manifestation depending on duration, severity of lameness, and stability of the distal phalanx/hoof wall interface. Accurate assessment of the whole patient is mandatory and consideration must be given to signalment, occupation, and owner expectations, as well as history and etiology, which often predict the broad course of the disease. Diagnosis is made via physical examination with adjunctive serial radiographic evaluation and possibly venography. Eventual functionality o...
Equine venography and its clinical application in North America. The digital venogram uses contrast radiography to evaluate the soft tissues and vasculature of the foot, thus identifying pathology attributable to laminitis. Pathology can be detected before changes appear on plain-film radiographs. When used in conjunction with clinical and radiographic findings, information gained from a venographic study informs and directs treatment. Serial venograms assess the response to treatment and help determine prognosis early in the course of therapy. If the venographic contrast pattern does not improve, either the treatment needs to be altered, or the damage is s...
[Swiss warmblood horse with symptoms of hereditary equine regional dermal asthenia without mutation in the cyclophylin B gene (PPIB)]. Hereditary equine dermal asthenia (HERDA) is an autosomal recessive skin disease that affects predominantly Quarter Horses and related breeds. Typical symptoms are easy bruising and hyperextensible skin on the back. The prognosis is guarded, as affected horses cannot be ridden normally and are often euthanised. In the Quarter Horse, HERDA is associated with a mutation in cyclophilin B (PPIB), an enzyme involved in triple helix formation of collagen. Here we describe the case of a Swiss Warmblood filly with symptoms of HERDA without PPIB-mutation and in which we also could exclude Ehlers-Danlos...
[Rupture of the extensor carpi radialis tendon in two horses]. Symptoms, diagnosis, therapy and clinical outcome of 2 horses which acquired a complete rupture of the extensor carpi radialis tendon by accident are described. The resulting gait abnormalities are very typical, so that the problem can be diagnosed already by clinical examination. With the help of ultrasound the diagnosis could be confirmed and the degree of damage quantified. The open wounds in the carpal region were surgically treated in a standing position and the limbs of both horses were kept under a splint bandage for 6 to 8 weeks. Prognosis in these cases was good, as both horses return...
Postoperative complications and survival after enterolith removal from the ascending or descending colon in horses. To compare incidence of postoperative complications and survival of horses that had surgery for enterolithiasis of the ascending (AC) or descending (DC) colon. Methods: Case series Methods: Horses (n=236) that had celiotomy for AC (n=97) or DC (n=139) enterolithiasis. Methods: Medical records (1999-2005) were reviewed for signalment, presenting clinical signs, surgical findings, postoperative complications, and short-term survival until discharge. Information on performance and survival > or = 1 year was obtained by telephone or mailed questionnaire. Results: Number of postoperative complic...
Acquired jejunal pseudodiverticula in a yearling Arabian filly. To report a case of multiple acquired jejunal pseudodiverticula managed successfully by resection and jejunojejunostomy. Methods: Clinical report. Methods: Arabian filly. Methods: The filly was referred for signs of acute colic of several hours duration and had a 2-week history of inappetence and weight loss. Three meters of thickened, edematous, and dilated jejunum removed during exploratory celiotomy had an intussusception and numerous diverticula; jejunojejunostomy performed. The pathoanatomic diagnosis was proliferative enteropathy with pseudodiverticula formation and jejunal muscular hype...
Long-term outcome after arthroscopic debridement of distal phalanx extensor process fragmentation in 13 horses. To report long-term outcome after arthroscopic removal of fragmentation of the extensor process of the distal phalanx in horses. Methods: Case series. Methods: Adult horses (n=13). Methods: Medical records (2003-2004) of horses that had arthroscopic debridement of fragmentation of the extensor process of the distal phalanx were reviewed. Inclusion criteria included: lameness localized to the foot, fragmentation of the extensor process of the distal phalanx debrided arthroscopically, and a follow-up period of > or = 4 years. Results: Of the 13 horses, lameness was resolved in 11 (85%) initia...
Retrospective study of 108 foals with septic osteomyelitis. To determine the clinical characteristics, short-term outcome and future athletic performance of foals with septic osteomyelitis. Methods: Retrospective clinical study of 108 Thoroughbred foals with radiographic evidence of bone infection that were presented at the Scone Veterinary Hospital between August 1995 and December 2001. Medical records were reviewed and information concerning signalment, the clinical, laboratory and radiographic findings, treatment and outcome was obtained. Racing records were obtained and evaluated for surviving foals that had reached racing age. Results: Mean age of...
Standing magnetic resonance imaging detection of bone marrow oedema-type signal pattern associated with subcarpal pain in 8 racehorses: a prospective study. The proximal metacarpal region is a common site of origin of lameness in the performance horse. A number of disease entities are recognised as causes of proximal metacarpal lameness but a definitive diagnosis is often elusive. Magnetic resonance imaging (MRI) is hypothesised to offer advantages over traditional imaging modalities in the investigation of proximal metacarpal pain. Objective: To describe clinical and imaging features of cases of lameness in racehorses arising from the proximal metacarpal region in which standing MRI identified 'bone marrow oedema-type' (BMO-type) signal patterns....
Concurrent or sequential development of medial meniscal and subchondral cystic lesions within the medial femorotibial joint in horses (1996-2006). Summary Reasons for performing study: Medial meniscal injuries and subchondral cystic lesions (SCL) are known to occur independently within the medial femorotibial (MFT) joint in horses. However, there are no reports of a potential clinical relationship between these 2 types of lesions. Objective: To: 1) document the concurrent presence or sequential development of medial meniscal and SCL of the medial femoral condyle within the MFT joint; and 2) determine the prognosis with both types of lesions. Methods: Retrospective case series of horses with both a medial meniscal and SCL of the medial fe...
Computed tomography of temporal bone fractures and temporal region anatomy in horses. In people, specific classifications of temporal bone fractures are associated with clinical signs and prognosis. In horses, similar classifications have not been evaluated and might be useful establishing prognosis or understanding pathogenesis of certain types of trauma. Objective: We hypothesized associations between temporal bone fracture location and orientation in horses detected during computed tomography (CT) and frequency of facial nerve (CN7) deficit, vestibulocochlear nerve (CN8) deficit, or temporohyoid osteoarthropathy (THO). Complex temporal region anatomy may confound fracture id...
Osseous abnormalities associated with collateral desmopathy of the distal interphalangeal joint. Part 2: treatment and outcome. There are currently few long-term follow-up data relating to recovery from injury of a collateral ligament (CL) of the distal interphalangeal (DIP) joint and limited information about the effect of associated osseous injury on prognosis. Objective: To describe long-term follow-up results for horses with CL injury, with and without associated osseous injury; and to determine the effect of extracorporeal shock wave therapy (ECSWT) or radial pressure wave therapy (RPWT) on outcome. Objective: Prognosis for return to performance for horses with CL-related osseous injury would be worse than for hor...
Osseous abnormalities associated with collateral desmopathy of the distal interphalangeal joint: part 1. Osseous abnormalities associated with collateral ligament (CL) injury of the distal interphalangeal (DIP) joint have been documented using magnetic resonance imaging (MRI) but there is currently limited information about the frequency of osseous pathology associated with CL injury. Objective: To determine the frequency of occurrence of osseous abnormality coexistent with CL injury of the DIP joint and describe the distribution and character of osseous lesions; and to establish if there was an association between osseous abnormality and increased radiopharmaceutical uptake (IRU). Objective: The...
Hematopoietic neoplasias in horses: myeloproliferative and lymphoproliferative disorders. Leukemia, i.e., the neoplasia of one or more cell lines of the bone marrow, although less common than in other species, it is also reported in horses. Leukemia can be classified according to the affected cells (myeloproliferative or lymphoproliferative disorders), evolution of clinical signs (acute or chronic) and the presence or lack of abnormal cells in peripheral blood (leukemic, subleukemic and aleukemic leukemia). The main myeloproliferative disorders in horses are malignant histiocytosis and myeloid leukemia, the latter being classified as monocytic and myelomonocytic, granulocytic, prim...
Uveal inflammation in septic newborn foals. Septicemia in humans is described as a leading cause of uveitis, which eventually can induce blindness. Objective: Uveal inflammatory findings could be related to sepsis severity in newborn foals and might be used as an indirect indicator for survival. Methods: Seventy-four septic foals, 54 nonseptic foals, and 42 healthy foals. Methods: Prospective observational clinical study. A detailed blinded, ophthalmic examination was performed by boarded ophthalmologists on all admitted newborn foals. Foals were grouped as septic (when blood culture resulted positive or the sepsis score was > or =14...
Venous blood lactate evaluation in equine neonatal intensive care. The use of blood lactate concentration as an indicator of prognosis and disease severity has become a common practice in equine medicine, especially with the validation of handheld analyzers. However, few authors described lactate concentration in critically ill foals, and there are no published studies about the use of handheld analyzers in neonatal foals. In this study, for the first time in the equine neonate, we validated the Lactate Scout analyzer, both in healthy and in critically ill foals. The study also describes the normal range for blood lactate in 26 healthy neonatal foals during t...
Sequential plasma lactate concentrations as prognostic indicators in adult equine emergencies. Sequential lactate concentration ([LAC]) measurements have prognostic value in that hospitalized humans and neonatal foals that have a delayed return to normolactatemia have greater morbidity and case fatality rate. Objective: Prognosis for survival is decreased in horses with a delayed return to normal [LAC]. Methods: Two hundred and fifty adult horses presented for emergency evaluation excepting horses evaluated because of only ophthalmologic conditions, superficial wounds, and septic synovitis without systemic involvement. Methods: Prospective observational study. [LAC] was measured at admi...
Predictors of response to immunosuppressive therapy with antithymocyte globulin and cyclosporine and prognostic factors for survival in patients with severe aplastic anemia. Immunosuppressive therapy (IST) with antithymocyte globulin (ATG) plus cyclosporine (CSA) is standard therapy in patients with severe aplastic anemia (SAA) who do not have an available HLA-matched sibling donor. Methods: The current study aimed to determine the predictive factors for response to IST in patients with SAA and to identify prognostic factors following IST. A total of 62 patients diagnosed with SAA who received IST with either rabbit ATG (n = 33) or horse ATG (n = 29) plus CSA between October 1994 and December 2007 were included. Results: With a median follow-up duration of 60.5 mo...
[Two horses with neurological symptoms: could this be equine botulism?]. Symptoms, diagnosis and therapy of equine botulism are discussed by the presentation of two detailed reports of horses with neurological symptoms and the results of laboratory investigations over the period 2003-2008 in the Netherlands. In addition a brief summary of the available literature is presented. Prevailing symptoms of botulism in horses include paralysis of the tongue, salvation, dysphagia and paresis and paralysis of the skeletal muscles, as well as signs of colic. Symptoms and prognosis vary with the amount of botulinum neurotoxin (BoNT) involved. For early clinical diagnosis of bo...
Management and assessment of prognosis after gastrocnemius disruption in Thoroughbred foals: 28 cases (1993-2007). Few studies have evaluated the athletic prognosis of foals affected by gastrocnemius disruption. Objective: To examine the diagnosis and management of gastrocnemius disruption in Thoroughbred (TB) foals, determine short-term survival rate and assess future racing performance. The hypothesis was that Thoroughbred foals with gastrocnemius disruption are able to perform as racehorses comparably to their age matched maternal siblings. Methods: The medical records of foals diagnosed with gastrocnemius muscle disruption were reviewed. Information on training and racing was acquired from published wo...
